<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset={$charset}">
<title>Edit Request</title>
</head>
<body>
{if isset($errors)}
{foreach from=$errors item=error}
{if isset($error)}<font color="#ff0000">{$error.message}</font><br />{/if}
{/foreach}
{/if}
{if isset($back)}
<a href="{$back}">戻る</a>
{/if}
<a href="/okute/request">メニュー</a>
<hr />
<form action="/okute/request/confirm" method="post">
必要な物資<input type="text" name="req_content" value="{$data.req_content}"><br>
数量<input type="text" name="req_amount" istyle="4" value="{$data.req_amount}"><br>
{if $shelter==""}
<pre style="color:red">あなたの避難場所を<a href="/okute/shelter/list">設定</a>してください</pre>
{else}
届け先:
{$shelter->prefecture|escape}
{$shelter->area|escape}
{$shelter->city|escape}
{$shelter->district|escape}
{$shelter->name|escape}
<br />
<a href="http://maps.google.com/maps?q={$shelter->lat_lng}+({$shelter->name|escape|google_maps_escape})">Googleマップ</a>
<br />
<p><a href="/okute/shelter/list">避難場所の更新</a></p>
{/if}
届け先付加情報<br>
<textarea name="addressee_notes">{$data.addressee_notes}</textarea><br />
緊急度
{html_options name=severity options=$severity_opts selected=$data.severity}
<br />
コメント<br>
<textarea name="notes">{$data.notes}</textarea><br>
<input type="hidden" name="csrf" value="{$csrf}">
<input type="submit" value="送信">
</form>
</body>
</html>